Unusual presentation of placenta increta in mid-trimester loss: A case report

Abstract

Introduction: Abnormal placentation is a major cause of maternal morbidity and mortality worldwide. There are three variants: placenta accreta, when the chorionic villi attach to the myometrium; placenta increta, in which placental villi extend into the myometrium; and placenta percreta, when the villi invade through the myometrium into the uterine serosa and may invade adjacent organs, such as the bladder. Previous caesarean section (CS) is the most important risk factor. The risk increases with the number of CSs. Other risk factors include uterine curettage resulting in Asherman syndrome and uterine anomalies. The diagnosis is established by ultrasonography and supplemented by magnetic resonance imaging (MRI). There are a number of different management approaches; conservative, methotrexate, uterine artery embolisation and balloon tamponade.